Tirzepatide Shows Promise as First Drug Therapy for Obstructive Sleep Apnea

Researchers from the University of California San Diego School of Medicine and international partners have conducted a significant study demonstrating the potential of tirzepatide, a medication primarily used for managing type 2 diabetes, as the first effective drug therapy for obstructive sleep apnea (OSA). This sleep disorder is characterized by repeated episodes of irregular breathing due to partial or complete blockage of the upper airway.

The study’s findings, published on June 21, 2024, in the New England Journal of Medicine, suggest that this treatment could enhance the quality of life for millions affected by OSA worldwide.

Lead author Atul Malhotra, MD, a professor at the University of California San Diego School of Medicine and director of sleep medicine at UC San Diego Health, highlighted the significance of this study, referring to it as a milestone in OSA treatment. He noted that the therapy addresses both respiratory and metabolic complications associated with the disorder.

OSA can lower blood oxygen levels and is linked to an increased risk of cardiovascular issues, including hypertension and heart disease. Recent estimates suggest that nearly 936 million individuals suffer from OSA globally.

The research included two Phase III, double-blinded, randomized, controlled trials with 469 participants diagnosed with clinical obesity who had moderate-to-severe OSA. Participants were recruited from nine countries, including the United States, Australia, and Germany, and were either using or not using continuous positive airway pressure (CPAP) therapy, the standard treatment for OSA.

Over a 52-week period, participants were given either 10 or 15 mg of tirzepatide via injection or a placebo. The results showed that tirzepatide significantly reduced the frequency of breathing interruptions during sleep, a key measure of OSA severity, outperforming the placebo group. Notably, some participants no longer required CPAP therapy after taking the drug. The research suggests that addressing both sleep apnea and obesity with drug therapy may be more effective than targeting either condition alone.

In addition to reducing the severity of OSA, tirzepatide also lowered cardiovascular disease risk factors and aided weight loss. The most commonly reported side effect was mild stomach issues.

Malhotra remarked that traditional OSA treatment depended on devices like CPAP machines, which require consistent use for effectiveness. He stated that the new drug treatment could offer a viable alternative for individuals unable to tolerate existing therapies. Malhotra emphasized that combining CPAP therapy with weight loss could optimize treatment for improving cardiometabolic risk and symptoms.

He views the development of a drug therapy for OSA as a significant advancement, potentially transforming how obesity-related sleep apnea is managed on a global scale. Malhotra expressed optimism that this could lead to a new standard of care for individuals struggling with existing treatment limitations.

The researchers plan to conduct further clinical trials to assess the long-term effects of tirzepatide.

Co-authors of the study include Ronald Grunstein from the University of Sydney; Ingo Fietze from University Hospital Berlin; Terri Weaver from the University of Illinois Chicago; and several researchers from Harvard Medical School, the University of Pennsylvania, and Eli Lilly and Company. Eli Lilly provided part of the funding for the study. Atul Malhotra is also a consultant for Eli Lilly.